儿科与新生儿科住院患者血培养病原菌及耐药性差异研究  

Contrastive Analysis of Pathogenic Distribution and Drug Resistance in Children and Neonatal of Blood Culture

作　　者：赖智润 王旌[1] 陈惠瑜[2] 邱华红[2] 钟汇 LAI Zhi-run;WANG-jing;CHEN Hui-yu;QIU Hua-hong;ZHONG Hui(Fujian Provincial Maternity and Children′s Hospital,affiliated hospital of Fujian Medical University,Infection-control department,Fuzhou 350001,China;Fujian Provincial Maternity and Children′s Hospital,affiliated hospital of Fujian Medical University,Clinical laboratory,Fuzhou 350001,China)

机构地区：[1]福建省妇幼保健院院感科,福建福州350001 [2]福建省妇幼保健院检验科,福建福州350001

出　　处：《海峡药学》2022年第12期141-144,共4页Strait Pharmaceutical Journal

摘　　要：目的了解儿科和新生儿科住院患儿血培养主要病原菌分布及耐药性,为临床抗感染治疗提供依据。方法收集2014年1月~2020年12月我院住院儿科和新生儿科血液标本分离菌株,采用法国生物梅里埃VITEK-2全自动细菌鉴定分析仪鉴定菌种,纸片扩散法(K-B法)进行药敏试验,应用WHONET 5.6软件对结果进行统计分析。结果我院儿科患儿血培养主要病原菌是嗜麦芽窄食单胞菌、大肠埃希菌、肺炎克雷伯菌、肺炎链球菌,以革兰阴性杆菌为主,占65.8%,其中嗜麦芽窄食单胞菌是最主要的病原菌,占40.9%,对磺胺甲噁唑/甲氧苄啶、米诺环素、左氧氟沙星、头孢哌酮/舒巴坦耐药率分别为3.2%、0%、1.1%、12.8%;儿科患儿血培养肺炎克雷伯菌对亚胺培南、美洛培南的耐药率高达23.1%,应引起重视。新生儿血培养主要的病原菌是凝固酶阴性葡萄球菌、肺炎克雷伯菌、大肠埃希菌、无乳链球菌。新生儿血培养以革兰阳性球菌为主,占62.3%,凝固酶阴性葡萄球菌是最主要的病原菌,占45.6%,MRCNS占87.3%;未出现万古霉素、利奈唑胺耐药株。结论我院儿科住院患儿与新生儿血培养的病原菌分布和耐药性明显不同,应对住院患儿血培养病原菌分布和耐药性加以关注。OBJECTIVE To investigate the distribution and drug resistance of main pathogens cultured from blood in hospitalized children and neonatus,so as to provide evidence for clinical anti-infective treatment.METHODS The strains were isolated and cultured from blood specimens of hospitalized children and neonatus from Jan 2014 to Dec 2020.The strains were identified by the VITEK-2 system and drug sensitivity was tested by K-B disk diffusion method.The WHONET 5.6 software was used to analyze the data.RESULTS The main pathogens isolated from blood samples of hospitalized children were Stenotrophomonas maltophilia,Escherichia coli,Klebsiella pneumoniae,streptococcus pneumoniae;Gram-negative organisms were main pathogens in hospitalized children(65.8%)and Stenotrophomonas maltophilia(40.9%)was the primary pathogens whose resistance rates to Trimethoprim/sulfamethoxazole,minocycline,levofloxacin,cefoperazone/sulbactam were 3.2%,0%,1.1%,12.8%,respectively.It is worth noting that the resistance rates of Klebsiella pneumoniae to imipenem,meropenem was up to 23.1%.The main pathogens isolated from blood samples of hospitalized neonatus were coagulase-negative Staphylococcus,Klebsiella pneumoniae,Escherichia coli and Streptococcus agalactiae.Gram-positive organisms were the main pathogens in hospitalized neonatus(62.3%)and coagulase-negative staphylococcus(45.6%)was the primary pathogens with 87.3%MRCNS.And all the strains were sensitive to vancomycin and linezolid.CONCLUSION There are significant differences in the distribution and drug resistance of pathogenic bacteria isolated from blood between hospitalized children and neonatus.It is important to pay attention to the distribution and drug resistance of pathogens cultured from blood in children and neonatus.

关 键 词：儿科患儿 新生儿 血培养 病原菌 耐药性 

分 类 号：R969.4[医药卫生—药理学]